Individual
MR. GARY ALAN BENDA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS
Contact information
Practice address
222 E MEDICAL LN STE 100&200, WEST COLUMBIA, SC 29169-4847
(803) 935-8410
(803) 936-7816
Mailing address
470 HULON LN, WEST COLUMBIA, SC 29169-4841
(803) 935-8410
(803) 936-7816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2579
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2733PA
—
SC
Enumeration date
08/15/2016
Last updated
10/07/2021
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